Adolescent idiopathic scoliosis causes pelvic floor dysfunction: A cross-sectional study

Background: Scoliosis is a complex three-dimensional deformity of the spine and causes spinal misalignment and pelvic structure changes. Objective: This cross-sectional study was designed to investigate the relationship between postural deviation, scoliosis angle and pelvic floor dysfunctions in individuals with adolescent idiopathic scoliosis (AIS). Methods: Twelve AIS aged between 12 and 18 years were included in the study. Standard scoliosis radiography was used for Cobb angle measurement. The posture screen mobile (PSM) application was used for determining postural deviation, and a real-time ultrasound image was obtained for pelvic floor muscle activity. The pelvic floor distress inventory was used for the evaluation of pelvic floor dysfunctions. Results: There was a significant negative correlation between bladder base elevation and the following variables, including thoracic and lumbar Cobb angles (r = -0.640, p < 0.05; r = -0.779, p < 0.05), Dysfunctional Voiding Scoring System (DVSS) (r = -0.753, p < 0.05), Pelvic Floor Distress Inventory (PFDI) (r = -0.722, p < 0.05) and Urinary Distress Inventory (UDI) (r = -0.585, p < 0.05). The apical shift in the frontal plane was found to be positively correlated with DVSS (r = 0.701, p < 0.05), UDI (r = 0.641, p < 0.05) and PFDI-20 (r = 0.628, p < 0.05) and negatively correlated with bladder base elevation (r = -0,615, p < 0.05). The average pelvic shift in frontal plan was found to be positively correlated with DVSS (r = 0.810, p < 0.05), PFDI-20 (r = 0.722, p < 0.05), Pelvic Organ Prolapse Distress Inventory (POPDI) and UDI (r = 0.626, p < 0.05) and negatively correlated with bladder base elevation (r = -0.626, p < 0.05). Conclusion: Scoliosis negatively affects pelvic floor muscle activity, and pelvic floor functions, resulting in urinary dysfunction. Pelvic floor assessment may be added to the evaluation process in patients with AIS.